In an independent, prospective, single-center investigator-initiated study of 62 total knee replacement patients in “fast track” surgeries, those who received an iTotal® CR had significantly better outcomes compared to patients who received a traditional “off-the-shelf” implant. Specifically, iTotal® CR patients had a significantly shorter length of stay than off-the-shelf patients (1.6 days vs. 2.7 days, p=0.004). Additionally, a higher proportion of iTotal® CR patients were discharged within 24 hours (66% vs. 30%, p=0.006) with a significantly higher proportion of iTotal® patients discharged directly to home (97% vs. 80%, p=0.0496) as opposed to a skilled nursing facility. Further, a significantly higher proportion of iTotal® patients were able to achieve range of motion greater than or equal to 120˚ (84% vs. 45%, p=0.003). This study was presented at the 2016 ICJR Pan Pacific Orthopaedic Congress.Based on the results of the study and other published economic data, Dr. Buch concluded that Conformis iTotal® CR has the potential to save hospitals approximately $2,200 per patient. The recent rollout of the Comprehensive Care for Joint Replacement (CJR) model has incentivized hospitals to better manage costs and care coordination for knee replacement patients. Under the CJR model, which has been implemented in 67 Metropolitan Statistical Areas, the Centers for Medicare & Medicaid Services (CMS) has a stated goal of saving $150 million over 5 years. Two of the most costly components across the entire episode of care for total knee replacements are the initial inpatient hospital stay and the use of rehabilitation facilities after discharge. Based on a previously published cost analysis of length of stay1, by shortening the average length of hospital stay by 1.1 days compared with off-the-shelf implants, Dr. Buch concluded that there is potential for in-hospital cost savings of approximately $1,100 per patient. Similarly, based on another previously published cost analysis of discharge destination2, Dr. Buch concluded that a lower proportion of iTotal® patients being discharged to skilled nursing facilities has the potential for an additional savings of approximately $1,100 per patient for a total potential savings of approximately $2,200 per patient.
Does Implant Design Affect Hospital Metrics and Patient Outcomes? TKA Utilizing a “Fast Track” Protocol 